Case Report
Ambulatory Anesthesia in an Adult Patient with Corrected Hypoplastic Left Heart Syndrome
Table 1
Preoperative evaluation.
| | PMH | Hypoplastic left heart | | Sick sinus with pacemaker | | Hypertension | | Cirrhosis | | Lung arteriovenous malformations |
| | PSH | Norwood (at birth) | | Glen (at 4 m) | | Fontan (at 5 y) | | Cholecystectomy | | Tonsillectomy | | Wrist surgery | | Esophagogastroduodenoscopy | | Cardiac cath |
| | Meds | Spironolactone | | Digoxin | | Atenolol | | Aspirin | | Hydrochlorothiazide | | Losartan | | Pantoprazole | | Potassium chloride |
| | Labs | Hemoglobin 17.5, platelets of 100 [nadir 50] | | AST 49, ALT 70 | | INR of 1.3 | | Na 123, K 3.7, Cr 0.73, HCO3 23 | | Albumin 4.8, total protein 7.2 |
| | EKG | Heart rate 79 bpm, atrial-paced with 1o AV block, right access deviation, | | incomplete right bundle branch block, right ventricular hypertrophy, | | ST depression in precordial leads with T wave inversion (nonacute) |
| | Echo | Grossly adequate myocardial function, no Fontan obstruction, unobstructed atrial septal defect, mild aortic regurgitation |
| | Cardiac Cath | Patent superior vena cava to right pulmonary artery conduit with a saturation of 88%, mean pressure of 14 mmHg, | | inferior vena cava to left pulmonary artery conduit with a saturation of 85%, mean pressure of 14 mmHg |
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